by Christopher Roach
Luigi Mangione and his fans showed us that millions of Americans have reached a point of such frustration that they are embracing even darker and more violent solutions to the failures of Obamacare.
The shooting of United Healthcare’s CEO, Bryan Thompson, has engrossed the public. The shooting itself was a well-planned and audacious act. But when police apprehended the handsome, Ivy League-educated killer, many were disappointed. They were rooting for him to escape.
The killing has proven more popular than I would have expected. Moreover, this popularity is not confined to the left wing. People across the spectrum have shared their frustrations with the healthcare system and found themselves sympathetic to the killer.
An All-American Murderer
When Luigi Mangione’s background and manifesto were revealed, he appeared to have a good life and a promising future. His social media suggested an intelligent freethinker, whose views and motives were neither clearly left- nor right-wing. He had his first significant encounter with the health system after a serious back injury, and the experience seems to have radicalized him.
His crime is a classic example of “propaganda by the deed.” People who acknowledge intellectually that murder is wrong seem totally unemotional about that conclusion. There’s widespread support for the shooter, while the victim has been dehumanized and reduced to a symbolic avatar for the industry and its sins.
Almost everyone has some story of being abused by the modern health insurance system. It’s even worse for the self-employed, who pay out of pocket for insurance. After paying premiums for years, the injured find themselves in a Kafkaesque battle with their insurance company over coverage, copays, and approved care.
The False Promise of Obamacare
It was not supposed to be this way.
Obamacare was supposed to provide universal coverage and make health care more affordable. After all, the law was called the Affordable Care Act. When the Obama administration proposed the law in 2009, it made many promises to sell it to the public and Congress.
One of the more famous ones was that “if you like your doctor, you can keep him.” Another was that if you like your insurance, you can keep that too. Finally, we were told this law would make us all healthier, as uninsured people would no longer wait until health problems became catastrophic before seeking care, typically in the emergency room.
This was the signature initiative of the Obama presidency, and the law has done none of these things. Care has become significantly more expensive. The quality of care has also gone down, with out-of-pocket expenses rising because of higher deductibles and out-of-pocket limits. Doctors are frequently dropped from plans, leaving patients unable to maintain continuity of care with those whom they have come to trust.
The country has not gotten any healthier, in spite of the enormous amount of money changing hands. The complexity of Obamacare has also led to the proliferation of highly paid billing specialists, administrators, and other overhead, none of which contributes directly to better care, but all of it costs money.
Employer-provided plans—which people like because they’re not taxed as income—remained largely untouched, with government workers receiving some of the most generous benefits of all.
Obamacare modestly expanded the percentage who had insurance coverage by loosening the requirements for Medicaid eligibility. It also mandated a complex system of income-based cross-subsidies within the individual insurance market.
Under Obamacare, people making more money paid full freight for themselves and also paid additional amounts to subsidize those at lower incomes. It did not take a lot of income until the full premium became due—the so-called “Subsidy Cliff”—often cutting dramatically into the profits of those who started small businesses or were self-employed.
This punishment of success and initiative was the most pernicious aspect of the law, a blatant giveaway to preferred Democratic constituencies and insiders, while also functioning as a de facto war on small business.
The Healthcare Experience Has Gotten Worse for Most People
There was, in fact, a robust system of individual insurance before Obamacare. I know because I had it. Back then, I was paying $200 a month for a plan with broad coverage and a $2,500 out-of-pocket limit. A few years into Obamacare, that plan just went away when my insurer canceled it without explanation.
Its replacement was $500 a month and had a $5,000 out-of-pocket limit. Blue Cross has raised the premium annually, but it was the best among a series of bad choices. It now costs $700 a month and has a $7,400 out-of-pocket limit. Those caps double if I go out of network for some reason.
Is the average person going to be able to pay $8,400 a year and also come up with another $7,000 if something bad happens? Also, these numbers double when a family plan is involved. In spite of having Obamacare coverage, large out-of-pocket expenses mean that many people are effectively uninsured.
At the time of the law’s passage, critics (on the left) said that mandating universal insurance coverage would simply be a giveaway to the insurance companies in the absence of a “public option.” By competing with private plans, the public option would serve as a price ceiling. The critics had a point.
Expense is not the only defect of Obamacare. There is also the massive, frustrating inconvenience of dealing with insurance companies. Doctors and patients alike have been worn down by the process. Wait times are long, customer service is indifferent, foreign call centers are common, and the decision-making rules are completely opaque.
Like most people, I’ve spent multiple hours wrangling for coverage of drugs and other care. It is exhausting, and it’s exhausting by design. The goal is to wear out customers and their doctors with long wait times, byzantine review processes, and incomprehensible paperwork requirements.
Even though a well-intentioned law was passed requiring price transparency, the law has no teeth. Thus, it is still nearly impossible to figure out what anything will cost in advance in order to shop around and reduce costs. Any hospital visit leads to months of bills, often from unknown third parties who claim to have provided services.
Obamacare was an overinclusive solution to a single problem: people being dropped from insurers because of preexisting conditions. However, the law ended up wrecking the entire healthcare system, making things worse for the millions of people who were satisfied with their doctors and their insurance.
I do not think Obamacare is a good idea, with or without a public option. Healthcare has become even more of a hybrid of government and markets. As we have seen in defense contracting and higher education, when the private sector and government get into bed with one another, costs go haywire while quality declines.
Today, I expect few people would come to the defense of the system, in contrast to the many who did so in 2008. The COVID episode drove a wedge of trust between patients and the healthcare system. And, even by its own standards, the Obamacare system is failing miserably at providing quality care, universal coverage, and controlling expenses.
In fact, its sustained expense and meager outcomes make people more inclined to look favorably upon socialized medicine, single-payer healthcare, or some other dramatic change to the system.
Luigi Mangione and his fans showed us that millions of ordinary Americans have reached a point of such frustration that they are embracing even darker and more violent solutions to the failures of Obamacare.
Christopher Roach
Source: https://amgreatness.com/2024/12/17/a-popular-killer-demonstrates-obamacares-failures/
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